[Remote] Revenue Cycle Coverage and Claims Associate I

Note: The job is a remote job and is open to candidates in USA. Exact Sciences is a company dedicated to changing how the world prevents, detects, and guides treatment for cancer. The Revenue Cycle Coverage and Claims Associate I will be responsible for accurately filing insurance claims and ensuring proper coverage and reimbursement processes while adhering to HIPAA regulations and maintaining confidentiality.

Responsibilities

• Maintain confidentiality and adhere to all HIPAA guidelines/regulations
• Determine initial or ongoing patient insurance eligibility verification for all claims, including commercial and government insurance to the plan coverage and product level
• Investigate and correct accounts within Epic and other systems/tools, including updates to patient demographics, financial information, and guarantor information
• Interact with various insurances/third party payors accurately and timely to ensure authorization is obtained and documented based on internal and external policies and regulations
• Research missing or erroneous information on accounts using various portals and other resources, including outreach and identification of unknown payors
• Stay current with relevant medical billing regulations, rules, and guidelines
• Provide ad-hoc support within the department for special projects and outages/high volume events
• Complete position responsibilities within the appropriate time frame while adhering to quality standards
• Ability to communicate effectively with all levels of staff through both verbal and written communications
• Ability to work in a team environment and adapt to changing workload and circumstances effectively; able to respond to new information quickly
• Ability to act in a professional manner in all interactions with members of the Exact Sciences clinical laboratory team, clients, and associates
• Ability to work with others in a spirit of teamwork and cooperation
• Excellent problem-solving abilities and organizational skills
• Disciplined, self-motivated and reliable; able to stay focused on a task and work independently; motivated to perform quality work; diligent about arriving to work on time and completing tasks that are assigned in a timely manner
• Possess a positive attitude
• Ensure compliance with all Company procedures and guidelines; including, but not limited to, Code of Business Conduct and Ethics
• Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork
• Support and comply with the company’s Quality Management System policies and procedures
• Maintain regular and reliable attendance
• Ability to act with an inclusion mindset and model these behaviors for the organization
• Ability to work designated schedule
• Ability to work overtime, as needed
• Ability to work in front of a computer screen and/or perform typing for approximately 90% of a typical working day
• You will be required to successfully complete an assessment showing understanding of Exact Sciences Epic processes necessary to the job functions with a score of 80% or higher. Exact Sciences will make a reasonable accommodation available, if necessary, to assist an employee with a disability to satisfy this requirement

Skills

• High School Diploma or General Education Degree (GED)
• 3+ months of experience in any healthcare field
• Strong knowledge of order management, insurance claims procedures, electronic health record (EHR) operating systems
• Basic knowledge of medical terminology and/or health insurance terms
• Demonstrated strong attention to detail and focus on quality output
• Proficient with electronic health records
• Proficient in Microsoft Office programs, such as Word and Outlook
• Demonstrated ability to perform the essential duties of the position with or without accommodation
• Applicants must be currently authorized to work in country where work will be performed on a full or part-time basis. We are unable to sponsor or take over sponsorship of employment visas at this time
• Associates Degree in field as outlined in the essential duties
• 1+ years of experience in the medical or insurance billing field
• Experience in revenue cycle platform applications
• Medical billing certification

Benefits

• Paid time off (including days for vacation, holidays, volunteering, and personal time)
• Paid leave for parents and caregivers
• A retirement savings plan
• Wellness support
• Health benefits including medical, prescription drug, dental, and vision coverage

Company Overview